With Republicans fighting the idea of a government-run health insurance plan, Obama administration officials said Sunday that they are open to a compromise: a cooperative program that would expand coverage with taxpayer money but without direct governmental control.
Congress begins work this week on putting President Barack Obama's goal of universal health coverage into law. But some lawmakers are expected to introduce specific plans that run counter to Obama's political promises.
The concessions could be the smoothest way to deliver the bipartisan health care legislation the administration seeks by its self-imposed August deadline, officials said.
"There is no one-size-fits-all idea," Health and Human Services Secretary Kathleen Sebelius said. "The president has said, 'These are the kinds of goals I'm after: lowering costs, covering all Americans, higher-quality care.' And around those goals, there are lots of ways to get there."
Some of those ways, though, run counter to the White House's earlier positions and Obama's own political base. While supporters from Obama's left have advocated a government-run option — championed by Sen. Edward M. Kennedy, D-Mass., and his surrogate, Sen. Chris Dodd, D-Conn. — presidential aides and congressional leaders in both parties have sought a speedy compromise.
Leading that pack: the cooperative approach, similar to rural utilities that have government financial support but operate independently. Sen. Kent Conrad, the North Dakota Democrat who chairs the Budget Committee, has offered the co-op idea as a way to avoid a bruising and protracted political wrangle on Capitol Hill.
"This really isn't, to me, a matter of right or wrong," Conrad said. "This is a matter of: Where are the votes in the United States Senate?"
That political situation has guided most of the talks. While Democrats control both chambers of Congress, they have only 59 senators — one short of the number needed to end a Republican filibuster. Even if Al Franken were seated as Minnesota's second senator, Kennedy and Sen. Robert Byrd, D-W.Va., are suffering health problems that could preclude them from casting votes to end the procedural delay.
"I think that, for virtually every Republican, a government plan is a nonstarter," said Senate Minority Leader Mitch McConnell, R-Ky. "There are a whole lot of other things we can agree to do on a bipartisan basis that will dramatically improve our system."
To reach that bipartisan solution — which the White House has emphasized — Democrats were likely to make concessions to find the $1 trillion the plan would cost over the next decade.
One way to get there would be to tax health benefits for families whose coverage costs $15,000 a year or more in premiums paid by employer and employee combined. Obama opposes the move.